Charged $1100 for two covid tests after being told it was free.

Hi everyone, hoping I can get some help on a Covid-test bill I received.

During 2021, I made several visits to an urgent care clinic in my hometown of New York City for PCR covid tests that I was required to have for work and business travel. The name of the clinic is Northwell Health Urgent Care. Each time, I was asked to present my health insurance card at the front desk upon check-in. Each time, the receptionist confirmed that my insurance was accepted by the clinic and I was told that I would incur no charges.

Yesterday, I received a bill from Northwell Health (the provider) for two visits in 2021 (one from July, one from September). The bill total is $1100. I was not charged for any of my other visits to the same clinic for the same PCR covid tests.

I immediately called the provider’s billing department. They told me that my insurance did not pay them for those two visits, but did pay them for my other visits. They advised to me to call my insurance company.

I called my insurance company, who looked into the claims and told me that the two visits in question were “coded” with a different claims code by the provider, as compared to the other visits from last year that were correctly coded and therefore fully covered by my insurance. They told me that I should call the provider and ask them to re-submit the two claims with the corrected codes.

So, I called the provider’s billing office and explained the story about the incorrect billing codes. They said they would look into it, and told me to hold off on paying the bill. However, they told me that while my PCR test itself is covered, the $1100 bill is actually for the two office visits at the clinic that occurred in order for me to get the two tests. This sounds kinda bogus – the entire purpose of my visit was to get a covid test and it’s impossible not to have an office visit to get the test.

See also  https://www.allzonems.com/2024-affordable-care-act-open-enrollment/

At this point, I am waiting for the provider to get back to me on their “investigation” into their incorrectly coded claims to my insurance. So, I’m not currently on the hook for the $1100, but if they come back to me and tell me that they reviewed my case and that I am responsible for the cost of the two office visits that went hand-in-hand with the PCR tests themselves, do I have any choice but to pay the $1100?

Any help/advice you all can provide would be greatly appreciated!